Long-term outcomes of thigh circumference, stifle range-of-motion, and lameness after unilateral tibial plateau levelling osteotomy

2010 ◽  
Vol 23 (01) ◽  
pp. 37-42 ◽  
Author(s):  
D. A. Allen ◽  
E. R. Wilson ◽  
J. A. Lineberger ◽  
T. Lehenbauer ◽  
E. M. Moeller
Keyword(s):  
Range Of Motion ◽  
Tibial Plateau ◽  
Long Term Outcomes ◽  
Thigh Circumference ◽  
Significant Difference ◽  
Control Limb ◽  
And Control ◽  
Flexion And Extension ◽  
Made In

SummaryOur study evaluated thigh circumference (TC), stifle range of motion (ROM), and lameness in dogs one to five years after unilateral tibial plateau levelling osteotomy (TPLO). We hypothesised that TC, stifle ROM, and lameness would not be different to the unoperated limb (control), one to five years after surgery. Patients that were one to five years post-TPLO were reviewed and were included if they had a unilateral TPLO, and no additional clinical evidence of orthopaedic disease. Standing mid-thigh TC measurements and stifle extension and flexion angles were made in triplicate. Clinical lameness was graded blindly. Data were evaluated statistically using paired t-tests for TC and stifle flexion and extension. Significance was set at p <0.05. Twenty-nine dogs met the inclusion criteria. Mean results for the surgery limbs and control limbs were 39.5 ± 5.5 cm and 40.1 ± 5.6 cm for TC, 36.6 ± 6.8° and 28.6 ± 4.3° for stifle flexion, and 155.2 ± 6.6° and 159.8 ± 4.9° for stifle extension, respectively. The mean TC for the operated limb was 98.5% of the control limb. A significant difference was found between the operated and the control limbs for all measurements. Time after surgery had no apparent affect on outcome. Four of 29 dogs (14%) exhibited some lameness in the TLPO limb during evaluation (one dog was 1 to 2 years postoperative and three dogs were 2 to 3 years postoperative). These results indicate that TC and stifle ROM in the TLPO limb do not return to control-limb measurements one to five years after a TPLO surgery. The clinical significance is unknown as TC returned to 98.5% of control, and the source of lameness in the lame dogs was not identified.

scholarly journals Female Sex and Outcomes after Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm: A Propensity Score Matched Cohort Analysis

2021 ◽  
Vol 10 (1) ◽  
pp. 162
Author(s):  
Christian-Alexander Behrendt ◽  
Thea Kreutzburg ◽  
Jenny Kuchenbecker ◽  
Giuseppe Panuccio ◽  
Mark Dankhoff ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Propensity Score ◽  
Acute Limb Ischemia ◽  
Insurance Claims ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Abdominal Aortic ◽  
Significant Difference

Objective: Previous studies have showed a potential disadvantage of female patients who underwent abdominal aortic aneurysm (AAA) repair. The current study aims to determine sex-specific perioperative and long-term outcomes using propensity score matched unselected nationwide health insurance claims data. Methods: Insurance claims from a large German fund were used, covering around 8% of the insured German population. Patients who underwent endovascular aortic repair (EVAR) for intact AAA from 1 January 2011 to 30 April 2017 were included in the cohort. A 1:2 female to male propensity score matching was applied to adjust for confounding variables. Perioperative and long-term outcomes after 5 years were determined using matching and regression methods. Results: Among a total of 3736 patients (19.3% females, mean 75 years) undergoing EVAR for intact AAA, we identified 1863 matched patients. Before matching, females were more likely to be previously diagnosed with hypothyroidism, electrolyte disorders, rheumatoid disorders, and depression, while males were more often diabetics. In the matched sample, 23.4% of the females and 25.8% of the males died during a median follow-up of 776 and 792 days, respectively. Perioperatively, females were more likely to exhibit acute limb ischemia (5.3% vs. 3.2%, p = 0.031) and major bleeding (22.0% vs. 15.9%, p = 0.001) before they were discharged to rehabilitation (5.5% vs. 1.5%, p < 0.001) when compared to males. No statistically significant difference in perioperative (odds ratio 1.12, 95% CI 0.54–2.16) or long-term mortality (hazard ratio 0.91, 95% CI 0.76–1.08) was observed between sexes. This was also true regarding aortic reintervention rates after 1 year (2.0% vs. 2.9%) and 5 years (10.9% vs. 8.1%). Conclusion: The current retrospective matched analysis of insurance claims revealed high early access-related morbidity in females when compared to their male counterparts. Short-term or long-term survival and reintervention outcomes were similar between sexes.

scholarly journals Randomized Controlled Trial of the Clinical Recovery and Biodegradation of Polylactide-co-glycolide Implants Used in the Intramedullary Nailing of Children’s Forearm Shaft Fractures with at Least Four Years of Follow-Up

2021 ◽  
Vol 10 (5) ◽  
pp. 995
Author(s):  
Marja Perhomaa ◽  
Tytti Pokka ◽  
Linda Korhonen ◽  
Antti Kyrö ◽  
Jaakko Niinimäki ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Controlled Trial ◽  
Long Term Outcomes ◽  
Intramedullary Nails ◽  
Metal Implants ◽  
Shaft Fractures ◽  
Fractures In Children ◽  
Significant Difference

The preferred surgical fixation of forearm shaft fractures in children is Elastic Stable Intramedullary Nailing (ESIN). Due to known disadvantageous effects of metal implants, a new surgical method using biodegradable polylactide-co-glycolide (PLGA) intramedullary nails has been developed but its long-term outcomes are unclear. The aim of this study was to compare the long-term outcomes of Biodegradable Intramedullary Nailing (BIN) to ESIN and assess the biodegradation of the study implants via magnetic resonance imaging (MRI). The study population of the prospective, randomized trial consisted of paediatric patients whose forearm shaft fractures were treated with BIN (n = 19) or ESIN (n = 16). Forearm rotation at minimally four years’ follow-up was the main outcome. There was no clinically significant difference in the recovery of the patients treated with the BIN as compared to those treated with the ESIN. More than half of the implants (57.7%, n = 15/26) were completely degraded, and the rest were degraded almost completely. The PLGA intramedullary nails used in the treatment of forearm shaft fractures in this study resulted in good function and anatomy. No unexpected disadvantages were found in the degradation of the implants. However, two implant failures had occurred in three months postoperatively.

A randomized trial of levamisole versus placebo as adjuvant therapy in malignant melanoma.

1991 ◽  
Vol 9 (5) ◽  
pp. 736-740 ◽  
Author(s):  
L E Spitler
Keyword(s):  
Malignant Melanoma ◽  
Adjuvant Therapy ◽  
Randomized Trial ◽  
Control Groups ◽  
Disease Free Interval ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
And Control

We conducted a long-term follow-up (median, 10.5 years) of patients included in a randomized trial of levamisole versus placebo as surgical adjuvant therapy in 203 patients with malignant melanoma. Of the patients randomized, 104 received levamisole, and 99 received placebo. The results show that there is no difference between the treatment and control groups with regard to any of the three end points analyzed. These included disease-free interval, time to appearance of visceral metastasis, and survival. Moreover, there was no significant difference between the treatment and control groups after adjusting for age, sex, or stage of disease.

scholarly journals What is the impact of methotrexate on liver in patients with juvenile idiopathic arthritis? Results of liver SWE performed in a single centre

2021 ◽  
Author(s):  
Vildan Güngörer ◽  
Mehmet Öztürk ◽  
Mustafa Yasir Özlü ◽  
Şükrü Arslan
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Shear Wave Elastography ◽  
Term Therapy ◽  
Control Group ◽  
Significant Difference ◽  
Group 2 ◽  
Long Term Therapy ◽  
And Control ◽  
The Impact

ABSTRACT Objectives Long-term therapy with low-dose methotrexate (MTX) is widely used in treatment of rheumatic diseases, in children. The purpose of this study was to evaluate liver elasticity in patients with juvenile idiopathic arthritis (JIA) who received MTX and compare the results with control group. Methods Liver elasticity was evaluated with shear wave elastography (SWE) technique in 25 patients aged 3–17 years who were followed up with JIA and received MTX and compared with 25 healthy controls of the same age and weight. Factors that had an effect on liver elasticity were examined. Results The mean SWE value of patients was 2.64 ± 2.13 m/s and 24.10 ± 18.50 kPa, whereas 1.83 ± 0.16 m/s and 10.09 ± 1.83 kPa in control group. There was a significant difference in liver elasticity in the patient and control groups. When the patients were evaluated as Group 1 (&lt; 1000 mg) and Group 2 (≥ 1000 mg) according to the cumulative MTX dose, no significant difference was obtained. There was positive correlation between liver elasticity and weekly MTX dose and age. Conclusions Our study revealed that liver elasticity significantly decreased in patients who received MTX when compared with the control group. The elastography technique will be understood better over time and used safely in many areas.

scholarly journals Effect of neck range of motion exercises on neck disability and pain among patients undergoing thyroidectomy

2020 ◽  
Vol 8 (4) ◽  
pp. 1
Author(s):  
Om Elhana Kamel Abo Shehata ◽  
Omima Said M.H. Shehata ◽  
Seham Mohamed Abd elalem
Keyword(s):  
Neck Pain ◽  
Range Of Motion ◽  
Neck Disability Index ◽  
Pain Scale ◽  
Control Group ◽  
Surgical Performance ◽  
Surgical Department ◽  
Significant Difference ◽  
Neck Disability ◽  
And Control

Objective: Thyroidectomy is a surgery in which head and neck became extended during operation to facilitate surgical performance. Patients experience neck pain and limitation to the range of motion following surgery. The study’s aim was to assess the effect of neck range of motion exercises on neck disability and pain among patients undergoing thyroidectomy.Methods: A quasi-experimental research design was utilized, the research was carried out at the surgical department in Shebin Emergency Hospital, at Shebin El-Kom District, Menoufia Governorate, Egypt. Sample; 90 adult subjects undergoing thyroidectomy and are welcoming to participate in the current research. Four Instruments for data collection: Instrument (1): Interview questionnaire sheet consists of two parts to assess subjects’ socio-demographic and medical data. Instrument (2): Visual analog pain scale to rate the patients’ level of pain intensity. Instrument (3): Neck disability index to assess neck pain and its effect on patients’ ability to perform daily activities. Instrument (4): Compliance assessment sheet to follow the patient’s adherence with neck range of motion exercise.Results: There was no statistically significant difference found between study and control group socio-demographic characteristics and medical history while there was a statistically significant difference between study and control group concerning neck disability and pain after one week and four weeks post-operative thyroidectomy.Conclusions: Patient compliance with a range of motion exercises significantly improves neck movement in order to be able to carry out daily life activities and reducing pain for the study group in comparison with the control group.Recommendation: Nurses who work in the general surgery department should include a neck range of motion exercises in providing the care and follow up protocol for the patients undergoing thyroidectomy.

scholarly journals The poor long-term outcomes of owl’s eye pulmonary reconstruction technique after arterial switch operation

2020 ◽  
Vol 31 (1) ◽  
pp. 113-120
Author(s):  
Mehmet Dedemoğlu ◽  
Oktay Korun ◽  
Gültekin Coşkun ◽  
Fatih Özdemir ◽  
Okan Yurdakök ◽  
...  
Keyword(s):  
Arterial Switch Operation ◽  
Reconstruction Technique ◽  
Reconstruction Method ◽  
Long Term Outcomes ◽  
Arterial Switch ◽  
Switch Operation ◽  
Significant Difference ◽  
Autologous Pericardial Patch ◽  
Group 1

Abstract OBJECTIVES This study aims to compare the early- and long-term outcomes of patients who undergo owl’s eye pulmonary artery (PA) reconstruction to those of patients who undergo conventional PA reconstruction. METHODS From January 2016 to January 2017, 64 consecutive patients underwent an arterial switch operation. The patients were divided into 2 groups in terms of neo-PA reconstruction method: 30 patients who underwent neo-PA reconstruction by owl’s eye technique were defined as group 1 and 34 patients who underwent neo-PA reconstruction by the conventional approach were defined as group 2. In the final model, after propensity matching, 23 patients from each group with similar propensity scores were included in the study. RESULTS There was no significant difference between the groups regarding patient characteristics and operative findings. In the early period, the duration of intensive care unit and hospital stays and the rate of mild neo-pulmonary stenosis (neo-PS) were significantly higher in the owl’s eye group (P = 0.04, 0.04 and 0.03). In the late period, the rate of severe neo-PS and reintervention was significantly higher in the owl’s eye group (P = 0.02 and 0.04). Furthermore, the rates of 3-year freedom from pulmonary reintervention and freedom from moderate–severe neo-PS were significantly lower in group 1 (P = 0.04). In addition, the owl’s eye reconstruction was the only factor independently related to moderate–severe neo-PS in the long term (hazard ratios = 11.2, P = 0.02). CONCLUSIONS We have abandoned the owl’s eye method for neo-PA reconstruction of the neo-PA because of serious complications. According to our series and the literature, reconstruction of the neo-PA with an oversized, pantaloon-shaped fresh autologous pericardial patch is still superior to the other techniques.

scholarly journals Liver Transplantation from Voluntary Organ Donor System in China: A Comparison between DBD and DCD Liver Transplants

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Wei Chen ◽  
Dipesh Kumar Yadav ◽  
Xueli Bai ◽  
Jianying Lou ◽  
Risheng Que ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Organ Donation ◽  
Survival Rates ◽  
Organ Donor ◽  
Long Term Outcomes ◽  
Significant Difference ◽  
Short And Long Term ◽  
Donor System

Background. In China, the cases of liver transplantation (LT) from donation after citizens’ death have rose year by year since the citizen-based voluntary organ donor system was initiated in 2010. The objective of our research was to investigate the early postoperative and late long-term outcomes of LT from donation after brain death (DBD) and donation after circulatory death (DCD) according to the current organ donation system in China. Methods. Sixty-two consecutive cases of LT from donation after citizens’ death performed in our hospital between February 2012 and June 2017 were examined retrospectively for short- and long-term outcomes. These included 35 DCD LT and 27 DBD LT. Result. Subsequent median follow-up time of 19 months and 1- and 3-year graft survival rates were comparative between the DBD group and the DCD group (81.5% and 66.7% versus 67.1% and 59.7%; P=0.550), as were patient survival rates (85.2% and 68.7% versus 72.2% and 63.9%; P=0.358). The duration of ICU stay of recipients was significantly shorter in the DBD group, in comparison with that of the DCD group (1 versus 3 days, P=0.001). Severe complication incidence (≥grade III) after transplantation was identical among the DBD and DCD groups (48.1% versus 60%, P=0.352). There was no significant difference in postoperative mortality between the DBD and DCD groups (3 of 27 cases versus 5 of 35 cases). Twenty-one grafts (33.8%) were lost and 18 recipients (29.0%) were dead till the time of follow-up. Malignancy recurrence was the most prevalent reason for patient death (38.8%). There was no significant difference in incidence of biliary stenosis between the DBD and DCD groups (5 of 27 cases versus 6 of 35 cases, P=0.846). Conclusion. Although the sample size was small to some extent, this single-center study first reported that LT from DCD donors showed similar short- and long-term outcomes with DBD donors and justified the widespread implementation of voluntary citizen-based deceased organ donation in China. However, the results should be verified with a multicenter larger study.

Function and Knee Range of Motion Plateau Six Months following Lateral Tibial Plateau Fractures

2019 ◽  
Vol 33 (05) ◽  
pp. 481-485 ◽  
Author(s):  
Anthony V. Christiano ◽  
Christian A. Pean ◽  
David N. Kugelman ◽  
Sanjit R. Konda ◽  
Kenneth A. Egol
Keyword(s):  
Range Of Motion ◽  
Tibial Plateau ◽  
Tibial Plateau Fractures ◽  
Lateral Tibial Plateau ◽  
Post Hoc Analysis ◽  
Time Points ◽  
Significant Difference ◽  
Friedman's Test ◽  
Post Hoc ◽  
Bicondylar Tibial Plateau

AbstractThe purpose of this study is to determine when functional outcome no longer improves following tibial plateau fracture. A patient series of operatively treated tibial plateau fractures was reviewed. Patients were evaluated using the short musculoskeletal function assessment (SMFA), range of motion (ROM) assessment, and pain levels at visual analog scale (VAS) at 3, 6, and 12 months postoperatively. Fractures were classified by the Schatzker's classification using preoperative imaging. The case series was divided into two groups based on fracture patterns. Friedman's tests were conducted to determine if there were differences in SMFA, ROM, or VAS throughout the postoperative course. A total of 117 patients with tibial plateau fractures treated operatively, with complete follow-up and without complication, were identified. Seventy-seven patients (65.8%) sustained lateral tibial plateau fractures (Schatzker's I–III). Friedman's test demonstrated significant differences in SMFA (p < 0.0005) and ROM (p < 0.0005) at the three time points. Post hoc analysis demonstrated a significant difference in SMFA (p < 0.0005) and ROM (p = 0.003) between 3 and 6 months postoperatively but no significant difference in either metric between 6 and 12 months postoperatively. Friedman's test demonstrated no significant difference in VAS postoperatively (p = 0.210). Forty patients (34.2%) sustained medial or bicondylar tibial plateau fractures (Schatzker's IV–VI). Friedman's test demonstrated significant differences in SMFA (p < 0.0005) and ROM (p < 0.0005) at the three time points. Post hoc analysis demonstrated a strong trend toward significance in SMFA between 3 and 6 months postoperatively (p = 0.088), and demonstrated a significant difference between 6 and 12 months postoperatively (p = 0.013). ROM was found to be significantly different between 3 and 6 months postoperatively (p = 0.010), but no difference was found between 6 and 12 months postoperatively (p = 0.929). Friedman's test demonstrated no significant difference in VAS postoperatively (p = 0.941). In this cohort, no significant difference in function, ROM, or pain level exists between 6 and 12 months after treatment of lateral tibial plateau fractures. However, there are significant improvements in function for at least 1 year following medial or bicondylar tibial plateau fractures.

scholarly journals Clinical features and long-term outcomes of moyamoya disease: a single-center experience with 528 cases in China

2015 ◽  
Vol 122 (2) ◽  
pp. 392-399 ◽  
Author(s):  
Xing-ju Liu ◽  
Dong Zhang ◽  
Shuo Wang ◽  
Yuan-li Zhao ◽  
Mario Teo ◽  
...  
Keyword(s):  
Clinical Features ◽  
Moyamoya Disease ◽  
Positive Impact ◽  
Chinese Patients ◽  
Single Center ◽  
Long Term Outcomes ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Revascularization Procedures

OBJECT The aim of this study was to describe the baseline clinical features and long-term outcomes of patients with moyamoya disease (MMD) based on a 25-year period at a single center in China. METHODS  Data obtained in 528 consecutive patients with MMD treated at the authors' hospital from 1984 to 2010 were reviewed retrospectively. Events of transient ischemic attack, new infarction, and hemorrhage were included. The Kaplan-Meier risk of stroke was calculated. RESULTS  The mean (± SD) patient age was 26 ± 13 years (range 2–67 years), and the female/male ratio was 0.9:1. There were 332 cases of ischemia and 196 hemorrhages. Adults had a higher rate of bleeding than children (50.7% vs 14.0%, respectively; p < 0.001). One hundred twenty-two patients were treated conservatively, and 406 patients underwent revascularization procedures. Of 528 patients, 331 (62.7%) had at least 1 year of follow-up (median 39.5 months) and data from these patients were analyzed. Rebleeding and mortality rates in patients with hemorrhagic MMD (n = 104) were higher than in those with ischemic MMD (n = 227) (26.9% vs 2.2% [p < 0.001] and 4.8% vs 0.4% [p < 0.05], respectively). Twenty-five of 60 (41.7%) conservatively treated patients and 8 of 271 (2.9%) surgically treated patients experienced rebleeding events, a difference that was significant in the Kaplan-Meier curve of rebleeding (p < 0.01). An improvement in perfusion was found in 164 of 224 (73.2%) surgically treated patients 1 month after discharge. However, there was no significant difference in the rate of ischemic events in the surgical and conservative groups (18.8% and 28.3%, respectively; p = 0.09). Among the 104 hemorrhagic cases, rebleeding attacks were observed in 25 patients in the nonsurgical group (n = 60) and 3 patients in the surgical group (n = 44) (41.7% and 6.8%, respectively; OR 9.7 [95% CI 2.7–35.0]; p < 0.01). CONCLUSIONS  There was no difference in the sex distribution of Chinese patients with MMD. Patients with hemorrhagic MMD had a much higher rate of rebleeding and poorer prognosis than those with the ischemic type. Surgical revascularization procedures can improve cerebral perfusion and have a positive impact in preventing rebleeding in patients with hemorrhagic MMD.

scholarly journals Neosuture formation after endoscope-assisted craniosynostosis repair

2016 ◽  
Vol 18 (2) ◽  
pp. 196-200 ◽  
Author(s):  
Afshin Salehi ◽  
Katherine Ott ◽  
Gary B. Skolnick ◽  
Dennis C. Nguyen ◽  
Sybill D. Naidoo ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Head Width ◽  
Long Term Outcomes ◽  
Sagittal Synostosis ◽  
Helmet Therapy ◽  
Age At Surgery ◽  
Significant Difference ◽  
Ct Data ◽  
Strip Craniectomy

OBJECTIVE The goal of this study was to identify the rate of neosuture formation in patients with craniosynostosis treated with endoscope-assisted strip craniectomy and investigate whether neosuture formation in sagittal craniosynostosis has an effect on postoperative calvarial shape. METHODS The authors retrospectively reviewed 166 cases of nonsyndromic craniosynostosis that underwent endoscope-assisted repair between 2006 and 2014. Preoperative and 1-year postoperative head CT scans were evaluated, and the rate of neosuture formation was calculated. Three-dimensional reconstructions of the CT data were used to measure cephalic index (CI) (ratio of head width and length) of patients with sagittal synostosis. Regression analysis was used to calculate significant differences between patients with and without neosuture accounting for age at surgery and preoperative CI. RESULTS Review of 96 patients revealed that some degree of neosuture development occurred in 23 patients (23.9%): 16 sagittal, 2 bilateral coronal, 4 unilateral coronal, and 1 lambdoid synostosis. Complete neosuture formation was seen in 14 of those 23 patients (9 of 16 sagittal, 1 of 2 bilateral coronal, 3 of 4 unilateral coronal, and 1 of 1 lambdoid). Mean pre- and postoperative CI in the complete sagittal neosuture group was 67.4% and 75.5%, respectively, and in the non-neosuture group was 69.8% and 74.4%, respectively. There was no statistically significant difference in the CI between the neosuture and fused suture groups preoperatively or 17 months postoperatively in patients with sagittal synostosis. CONCLUSIONS Neosuture development can occur after endoscope-assisted strip craniectomy and molding helmet therapy for patients with craniosynostosis. Although the authors did not detect a significant difference in calvarial shape postoperatively in the group with sagittal synostosis, the relevance of neosuture formation remains to be determined. Further studies are required to discover long-term outcomes comparing patients with and without neosuture formation.

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